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In the United States, 1 in 9 babies is born prematurely, 1 in 10 in Canada. Worldwide, over 15 million babies are born too soon each year. While not all multiples are born prematurely, a multiple birth increases the probability of an early delivery. Babies born prematurely, before 37 weeks gestation, are at a higher risk for health complications in infancy, some of which can have long-term effects. Full-term infants are not all free from their own health complications, of course.

In honor of November’s Prematurity Awareness Month, led by the March of Dimes, How Do You Do It? is focusing this week’s posts on The Moms’ experiences with premature deliveries, NICU stays, health complications, special needs, and how we’ve dealt with these complex issues.

Ella and Zoë were preemies. They were born a little over 10 weeks early and spent 47 and 57 days in the NICU.

They had many issues to overcome, though not nearly as many as they probably should have had. They were fighters from the get-go, like all preemies are. They had to work hard to be able to do things a full-term baby is easily able to do on its own. They needed a lot of help and were given that help by the most amazing NICU nurses and doctors. They are alive today due to medical advances which were brought about by the research funded by the March of Dimes.

They are now 7 1/2 years old, and you would never be able to tell they were premature, by either looking at them or talking with them. I think Ella and Zoë have quite the story to share, and this week I am joining in with hundreds of other parents and bloggers in the Fight for Preemies to help raise awareness and fight… because babies shouldn’t have to.

Ella and Zoë’s story started many years ago when Tom and I first began our journey of trying to become parents.

During our ‘trying to have a baby’ stage (a stage that lasted many years) we spent a lot of time at doctor’s offices, we had lots of appointments and procedures, we had lots of disappointments. We also learned how to keep trying after many negative pregnancy tests, and we also learned how to move forward after painful losses.

Then we found out I was pregnant again. We got the positive and started celebrating. Cautiously.

I started bleeding at 6 weeks (at 11pm) and we spent that long night together and braced ourselves for more bad news. We were beside ourselves when we saw not one, but TWO hearts beating strongly on the ultrasound screen. We were going to have TWINS!!

Then at almost 12 weeks there was more bleeding, and that’s when we found out Baby A’s placenta (Ella’s) was starting to detach.

That was the beginning of my 8 weeks of bed rest.

At 24 weeks preterm labor started and so did my time in the hospital.

A little over 10 weeks early, due to a really bad case of preeclampsia that turned into the beginning stages of HELLP syndrome — (I gained 19 pounds over the weekend), my doctor decided it was time for us to meet the babies. We were super excited but very nervous that it was too early. On Wednesday, April 19th (29 weeks 6 days) at 6:49 pm, Ella Marie was born. We named her after Tom’s mom, Della Marie, and her name means ‘Light’. She weighed 2 pounds 14 ounces and was 16 inches long. She was perfect.

At 6:51 pm, Zoë Dianne was born. We named her after my mom, Dianne, and her name means ‘Life’. She weighed 3 pounds 5 ounces and was also 16 inches long. She was also perfect.

Ella

Zoë

Even though we were nervous, the c-section went well and was so amazing. Ella, the tiny peanut that she was, came out crying pretty strongly for such a little thing. Zoë had swallowed more amniotic fluid so her first cries sounded more like a kitten rather than a baby, but to Tom and me hearing both girls make noises (their lungs were working!) was the best sound we’ll probably ever hear in our lifetime.

After the initial assessment by their own team of neonatal doctors and nurses both girls appeared to be overall very healthy and only required room air oxygen to help with their breathing. Hearing that news was such a relief! (Most preemie problems are respiratory related.) Even though they were only almost 30 week gestational babies they were doing so well!

Before they were taken out of the operating room the nurses brought Ella over to me first and then Zoë. Ella had been crying since her grand entrance but stopped when I started talking to her, my heart melted. Because Zoë had swallowed more amniotic fluid her team was in more of a hurry to get her to the Neonatal Intensive Care Unit (NICU), so instead of talking to her I gave her a little kiss on her forehead. It was probably a reflex, but that little sweetie leaned forward and kissed my nose! My heart melted again.

During the first few days of Ella and Zoë’s lives they each had a lot of different things done to them, including IVs (which they did not like, and often pulled right out), feeding tubes, and being attached to monitors for pulse, oxygen content, respiratory and blood pressure. Both had brain ultrasounds done a couple of times, and we were relieved to hear they each had “normal brains” (meaning no bleeding or swelling). The girls did need to pass a few tests before they could come home. They needed to breathe on their own and Ella needed to stop having her apnea spells; they needed to regulate their own body temperatures; and they needed to learn how to suck, swallow and breath, all at the same time.

On the fifth day of Ella and Zoë’s life I was finally well enough to go to the NICU.

It was the first time I remember holding Ella and the first time I actually held Zoë.

My sister was with me and she also had a chance to hold Ella

. . . . and Zoe, too.

And so began our life at our Home Away from Home — the NICU.

Zoe and Ella ~ 2 1/2 weeks oldFirst time together since their birth.

Zoe with her eyes open.

Ella with her eyes open.

Zoe and Ella at one month old.

Wearing their fairy outfits made to fit a teddy bear.

Ella at 6 weeks old.

Zoe at 6 weeks old.

Ella.

Zoë

It was a ‘one step forward two steps backwards’ type of dance those first few weeks but we were lucky. Ella and Zoë did really well, especially considering all of the ‘what could have beens’. And we had THE BEST PRIMARY NURSES ever!!

We will always be grateful for the care that Molly,

Cori,

Denise,

and Becca gave our daughters.

Leaving them each night would have been much more difficult it weren’t for those four nurses, as well as all of the other amazing staff that helped take care of our girls.

After 47 days we brought Zoë home!!

Zoë’s first car ride.

It was somewhat bittersweet though as Ella needed to stay in the hospital a bit longer, but the only way we were able to leave Ella was because Nurse Molly was there to hold her for us. Again,we’ll always be so grateful.

Ella recovering from her infection. She was a pretty sick little girl for over a week.

So for 10 days we learned how to parent a single baby at home while also spending time in the NICU helping Ella recuperate from her infection. On day 57 we brought Ella home and FINALLY, all four of us were under one roof!!

We were ready to start the next exciting chapter in our lives . . . A life that included a heart monitor for Ella, a pump, bottles, feed schedule every 3 hours (because both girls couldn’t swallow on their own and needed their milk thickened) that took 45 minutes to accomplish if everything went well . . . and lots of playing, smiles, cuddles and love. It took some time to get into a routine, and we didn’t get a lot of sleep those first few months, but eventually our days were more often less chaotic than chaotic ☺.

In the United States, 1 in 9 babies is born prematurely, 1 in 10 in Canada. Worldwide, over 15 million babies are born too soon each year. While not all multiples are born prematurely, a multiple birth increases the probability of an early delivery. Babies born prematurely, before 37 weeks gestation, are at a higher risk for health complications in infancy, some of which can have long-term effects. Full-term infants are not all free from their own health complications, of course.

In honor of November’s Prematurity Awareness Month, led by the March of Dimes, How Do You Do It? is focusing this week’s posts on The Moms’ experiences with premature deliveries, NICU stays, health complications, special needs, and how we’ve dealt with these complex issues.

It’s been a humbling experience to read the so many brave stories that have been contributed as part of the Prematurity Awareness week on HDYDI. I stand in sisterhood with all those who have shared their heart stories and am blessed and grateful to be able to share my birth story.

This time 3 years ago, I picked up my hospital bag and headed to Methodist Hospital Houston to deliver my fraternal twin girls. I was 39 weeks pregnant. I didn’t know what to expect and I didn’t have a birth plan. I was going to wing it on hope and prayer because in my wildest dreams, I did not imagine an ending as surreal and ordinary as me walking into labor and delivery to have twin babies on just another Tuesday.

At 8 weeks pregnant, I started bleeding and this continued for 7 more weeks. My doctor put me on bed rest and I worked from home lying down on the couch. With every doctor’s visit, my heart was in my mouth until I got confirmation of 2 heartbeats. Then I could breathe again.

At 31 weeks pregnant, I was diagnosed with a shortened cervix. My doctor said all the indicators showed that if my cervix continued to change at the same rate, I would deliver my babies within 3 weeks unless I went on a very strict bedrest. I spent the next 5 weeks at home in bed; only getting up for 10 minutes at a time to eat and shower

At 36 weeks pregnant, I exhaled. I finally called my parents, family and friends and told them that I was pregnant. I know I left it late, I just couldn’t bear the thought of sharing more bad news with them should something happen with my high-risk pregnancy. Living so far away from most of my family and friends made it all the more easier to be silent about my pregnancy.

Finally it was the 16th of November 2010 and I went to the hospital for a scheduled induction. I changed into the hospital gown and settled in. After 10 hours of watching TV and epidural-induced motionlessness, I was wheeled into the operating theater. Around 7pm Houston time, my baby A announced herself to the world with the sweetest little cry. I think that moment of knowing “yes, she made it!” would stay with me forever. I was ready to meet my second child

But nothing happened. The doctor started asking for instruments. A few minutes later, a second and more senior doctor walks in. They confer and then he comes to my side of the bed and tells me my second baby’s heartbeat is getting weaker. I just stared at him blankly like he was speaking Greek. I had spent the last 39 weeks in a deliberate state of emotional numbness and I wasn’t coming out of it soon. They installed heart rate monitor for her and I waited some more. A few minutes later, the doctor ask me if I wanted them to use a vacuum to deliver the baby. I said no I’d prefer to push. After 2 pushes and the scariest 20 minutes of my life, my second baby girl was born.

3 years later, the birthday party is over and the girls have finally settled in bed. It’s mama’s time to write the story of the day they were born.

I know a lot of women pregnant with twins will come to this website for advice and find it. I know they’ll read all the shared stories and wonder how their story will be written. I hope that they’ll feel the love and hope in all the stories that have been shared this last one week. I want them to know that 3 years ago, I had 2 sets of premmie clothes in my hospital bag that my girls did not get to wear. I want them to know that many paths lead to destination motherhood and each path has its own story. Thank you for letting me share mine.

Yetunde-Olusola is the proud mom of twin girls, affectionately nicknamed Sugar and Spice. She blogs at mytwintopia and loves to share tips and resources based on her personal parenting experiences in the hopes that she stops some frazzled twin parent from re-inventing the wheel.

In the United States, 1 in 9 babies is born prematurely, 1 in 10 in Canada. Worldwide, over 15 million babies are born too soon each year. While not all multiples are born prematurely, a multiple birth increases the probability of an early delivery. Babies born prematurely, before 37 weeks gestation, are at a higher risk for health complications in infancy, some of which can have long-term effects. Full-term infants are not all free from their own health complications, of course.

In honor of November’s Prematurity Awareness Month, led by the March of Dimes, How Do You Do It? is focusing this week’s posts on The Moms’ experiences with premature deliveries, NICU stays, health complications, special needs, and how we’ve dealt with these complex issues.

I’ve told my story so many times, you’d think I’d be able to write it down too. I’ve given talks to women’s groups and loss groups about it, done blog posts about it, etc., but something about this one is different. Maybe it’s because I know the audience reading this will be different… you’ll be in the thick of preemie-hood or the NICU or bed rest and you’ll want comfort and hope…

And I won’t be able to give you those things… Well, not in the way you’d expect at least. You see, my birth story ended with the loss of one of my triplets. I don’t want to scare you – having a preemie doesn’t mean you’ll experience loss too – but I do want to be real with you. One of the most real things I can do or say is this… my hope comes from knowing he made a difference in his 49 days of life. It comes from seeing his surviving brother and sister meet milestones and overcome obstacles. It comes from knowing that my story gets to be told and that it matters. And I hope you’ll feel that hope in what you read today, and not the sadness of loss.

I got married in 2007 and always knew I’d be a mom. We got pregnant right off the pill a year later, but sadly, we miscarried. We. Were. Devastated. I never thought I’d be dealing with miscarriage. Or what came next. Three years of infertility, another miscarriage, 2 rounds of IUI, and finally – finally – we were pregnant.

With triplets.

I was scared all over again. I was placed in the high-risk category. We nervously counted down the weeks and each week were surprised that all was going well. I had a shortened cervix, so I had a cerclage placed. At 22 1/2 weeks, I was placed on home bed rest to slow things down a bit. But that only lasted 2 weeks, and I was off to the hospital for a month of bed rest there. It was an experience that stuck with me so much, I even wrote a book about it.

Now the goal was to keep the babies cooking as long as possible. After 11 days, Baby A’s water broke, but he stuck in there for 19 more days.

From before birth, Carter fought to live. He fought to help his brother and sister live. While I was in the hospital on bed rest, his sac ruptured 19 days before his birth, leaving him unprotected. Because he was able to stay in, his brother and sister were able to continue to grow.

It would be food poisoning that would finally do me in. 2:30 a.m. and I was in full blown contractions. They couldn’t stop them, and I delivered my trio at 27 weeks and 5 days at barely 2lbs5oz each. My mom was in Hawaii. I’ll never forget how crushed she was to not be there. They were immediately taken to the level 3 NICU and I was taken to recovery. I don’t remember much about that first 12 hours. I do remember that at one point, my husband had to tell me some bad news, and I was so drugged up that I just kept encouraging him like it was happening to another baby and not ours.

At birth, Carter was the weakest. On the first day, the doctors didn’t think Carter would survive. His lungs weren’t working. After a tense few hours, it was evident Carter was a fighter as he survived his first brush with death.

Those first few days they were in the NICU weren’t too hard, probably because we were still in shock and adjusting to the reality of things. It was the day of discharge for me that things got real. We got bad news on all three of them. It was the first time I cried. I wouldn’t cry again for 44 days…

During his first few days of life, he struggled with high glucose, needing high oxygen support, and needing morphine and blood transfusions. Little did we know this was just the beginning. The doctors also discovered that he and his siblings all had E Coli sepsis, which wreaked havoc on their lungs and caused them to have brain bleeds. They were diagnosed with level 3 and 4 brain bleeds and hydrocephalus, a condition which can lead to cerebral palsy or other issues.

At home, I focused on pumping – getting over 70 ounces a day of the liquid gold. It kept me sane, giving me something to do for the babies. I went to the NICU every single day. I think I might have missed one day in total. I had to be there. I had to.

After only a week of life, Carter started to experience edema, and we began to lose the baby we knew and see a more swollen boy. He would live the rest of his life with this challenge, getting up to 6 ½ pounds at one point when he should only have been around 4 pounds at the time of his death. Throughout the weeks, Carter’s journey would be one of constant ups and downs. He would have a good day, only to have a bad day the next. After about two weeks of life, we began to discuss the possibility he might not survive this journey. We kept our faith and refused to give up on our little boy.

Each baby had their ups and downs. Braden had ruptured bowel at 7 days old, Tenley and Braden both had to be transferred to a higher-level hospital and had surgery for their brain bleeds that first night there. She’d have 2 surgeries by the time she left 86 days later, and he’d have 4 surgeries and leave after 111 days.

Even when Braden & Tenley continued to make progress and moved to a different hospital, we did not give up hope that Carter would recover and be well enough to make the move with them. But, the night of their transfer, we were told he only had a 10% chance of making it. We still remained hopeful, and our boy still fought. For the next few weeks, we had many ups and downs, many times we didn’t think he’d make it. At one point, we said our goodbyes and made peace with everything that might happen to him. We knew he’d be going to a better place, and we knew we’d be okay too.

So many emotions coursed through my body during these days. It was unbelievably hard. It tested my faith, my marriage, my friendships, my everything. I was in a whole new world. I could spout off terminology like I was one of the doctors in the NICU. I kept a detailed journal of everything – the updates, the records, the stats – everything. It was another way I stayed sane.

Then, things took a turn for the worse as his kidneys shut down and he was on full support. But, they also took enough of a turn for the better that a small window of opportunity was found to transfer him to the same hospital his siblings were. One last chance. After he was moved, he made great strides. He fought hard, and he won several battles. He was coming out of the woods…

Tenley would eventually get contaminant meningitis at the site of her brain surgery opening, which sent her back to level 3 and almost took her life. It might not have been that bad to deal with, except for the fact that it happened at the same time as we were losing Carter.

At the same time as Tenley was back in level 3, Carter wasn’t keeping his stats up and was weakening. They couldn’t figure out why. They did what they could, but it didn’t look good. He hung in there for awhile, but that Thursday night, his stats dropped very low – dangerously low – and they couldn’t get him stable again. We were called, and we came. They found that fluid had filled his lungs. He had an infection – the deal breaker, we knew. And, it was time to let him go.

It was my husband who finally came to the decision to let him go. And I had to let him make that decision. As cowardly as it may seem, I couldn’t do it. Sure, I said goodbye and I made my peace, but I couldn’t bring myself to say those words to the doctors.

We held him on Friday, the 27th for his last 2 hours of life and for the very first time in his entire life… we watched him slip away, and we comforted him during his last moments as we sent him off into Heaven, knowing we’d see him again one day. He fought right up until the end. He helped save his brother and sister, and we believe he touched many lives with his fight and his story…

It had been 44 days since I cried. I tend to only cry when I’m frustrated or angry. Sometimes when I’m overwhelmed, but rarely when I’m sad. But, I cried. I lost it. Hyperventilated when the doctors took him off the machines. Maybe I was mad at the world in that moment, I don’t know…

I only cried a few times in the weeks after. Something in me knew I had to keep going for my survivors. I was still in the thick of it and needed to focus on them. I think I made a conscious decision to choose to be okay. I wanted to celebrate the 49 days I had with him, and not mourn what I wouldn’t have in the years to come. This perspective is what gave me hope and allowed me to move on. Granted, I did have emotional affects from the experience and had a bout with post-tramatic stress disorder, especially once both his siblings came home – and he didn’t.

All this is hard to hear – and write – but it needs to be shared. It’s one of the unfortunate realities of having a preemie. It’s why the research and the support and all the community surrounding it is so important. It’s why my husband and I do a yearly fundraiser and are in the process of forming a non-profit. You can actually participate in this year’s fundraiser currently by going here.

I do want to end on a positive note… today, Braden and Tenley are about to turn two. They’re thriving, overcoming obstacles, hitting milestones, and making us feel blessed in every way. Yes, they’re preemies. But they’re more than that. They’re fighters. Survivors. Miracles. And, they’re my gift.

In the United States, 1 in 9 babies is born prematurely, 1 in 10 in Canada. Worldwide, over 15 million babies are born too soon each year. While not all multiples are born prematurely, a multiple birth increases the probability of an early delivery. Babies born prematurely, before 37 weeks gestation, are at a higher risk for health complications in infancy, some of which can have long-term effects. Full-term infants are not all free from their own health complications, of course.

In honor of November’s Prematurity Awareness Month, led by the March of Dimes, How Do You Do It? is focusing this week’s posts on The Moms’ experiences with premature deliveries, NICU stays, health complications, special needs, and how we’ve dealt with these complex issues.

A guest post from Ashley, whose identical twin boys — now almost seven years old — were born at the end of her second trimester.

After two years of trying to conceive, I finally saw those two beautiful pink lines on a home pregnancy test. It just so happened to be Father’s Day, 2006. With tears streaming down my face, I was so excited to tell my husband, “Happy Father’s Day!”

When I went in for my ultrasound appointment at 19 weeks, we got a huge surprise. “Are you ready for twins?” the ultrasound tech asked me. “No, and that’s not a funny joke, either!” I told him. He laughed and told me it was no joke and turned the monitor towards me. I saw two perfect little beings mirrored one above the other. I was having identical twin boys who had kept their presence unknown from me or the doctors for this long.

That day I was also told that I was now very high risk because the boys shared the same placenta and they thought that they also shared the same amniotic sack.

At 20 weeks gestation, I met with my new group of high risk doctors, 140 miles away. After my first ultrasound, I was told by my main doctor’s colleague that my boys suffered from Twin-to-Twin Transfusion Syndrome and that I would never carry them to a viable term. He said I should make peace with the fact that I would be burying my children and not taking them home.

Fortunately, I was quickly told by the doctor I was sent to see that they did not know for sure that it was TTTS, but from the small size of Baby B they suspected this to be true. He then proceeded to tell me that my cervix was extremely too short, ½ cm when it was supposed to be 3 cm, and that I would have to have a cerclage before any other doctors would or could take care of me and my babies.

After that procedure was completed, he then sent me to Cincinnati Children’s Hospital. This was one of only two hospitals that were equipped to handle TTTS patients. I arrived there at 5:00 in the morning for an MRI, genetics testing and two very detailed ultrasounds. On my second day there my parents and I met with the team of doctors working on my case. They told me that I did not have TTTS but I had an incompetent placenta that was not providing my baby B the nutrition he needed to grow. I was to continue care with my high risk OB and take it day by day.

Fast forward to 25 weeks gestation. I had been on very strict bed rest for the past 5 weeks at this point; I was only allowed to get up on my feet to shower and use the restroom. I went in for my weekly appointment on the Tuesday before Thanksgiving. I asked my doctor if I would be able to go home for the holiday, as by that time I was living 3 hours away from my family due to my husband’s new job. He said he didn’t see what that would hurt, everything looked good, but I was due to be back for my appointment the next Tuesday.

I enjoyed a wonderful holiday with my family and looked forward to seeing my growing babies the next week. When I got to my appointment, my second favorite doctor was seeing me that day. She prepped me for my ultrasound and I lay there and enjoyed seeing my boys on the big screen. After it was done she looked at me and told me I was not going home until the boys arrived.

Baby B was suffering from diastolic blood flow disorder and if he became distressed it could go bad fast and we could lose him as well as brother. She needed me where they could monitor him. I was at 26 weeks and 5 days at this point. I made camp in the room I thought would be mine for another 14 weeks; little did I know that the doctors and NICU team had other plans.

I had doctors coming in and checking the boys and talking to me about what was going on that day and the next day. My wonderful father saw how overwhelmed I was becoming and asked the Neonatologist, “If this were your wife or daughter, what would you do?” The doctor looked at us and told us they were better out than in; my boys had an 80% chance of survival at this gestation, and if I were his wife or daughter he would deliver and not risk losing one or both of the boys.

My tiny little boys were delivered that Friday, December 1, 2006, at 27 weeks and 2 days gestation, 13 weeks before they were scheduled to arrive. Baby A weighed 2 pounds 3 ounces and was 13 inches long; Baby B weighed 1 pound 14 ounces and was 12 inches long. We started our NICU ride and were prepared for the rollercoaster.

Our Baby A did great; he was a feeder and a grower. He came off the ventilator 8 days after he was born and went home 52 days after his NICU journey began, weighing in at 5 pounds.

Our Baby B had problems, though; he was on a ventilator for 32 days, had several infections and required several blood transfusions. There were times we worried about the fate of our littlest one. We never lost our faith that he would come home, but as any mom would, you worry about your child when the doctors look at you and tell you all they know to do is pray. He had to have a hernia repair on February 13, 2007, and that helped him a lot with his breathing. We finally brought him home on my due date of February 28, after 89 days in the NICU. He was still on oxygen and 9 different medications, but he was finally home where he belonged and weighed in at a whopping 6 pounds 6 ounces at 3 months old! He came off his oxygen 3 months after he came home.

While in the NICU baby B failed his newborn hearing screen twice. We found out that he had severe to profound hearing loss in the left ear and mild to moderate hearing loss in the right ear when he was 6 months old. He was fitted with his first set of hearing aids on July 22, 2007, and we started speech therapy that same month.

Fast forward to today…my boys will soon be 7 years old! They are in the 1st grade and are doing amazing! To look at them you would never know they had such an early start. They both are accelerating in school and their teachers are just amazed at the knowledge these boys already have. Baby B is going to get his third set of hearing aids in the next week and is doing great in that regards.

My boys are my little miracles, I am so very grateful for them every day. Sadly the strain of having two sick children and other personal issues that never fully became resolved took a toll on my marriage. Their father and I divorced in 2011. I am thankful to report that we have remained very good friends and co-parent the boys very well.

In the United States, 1 in 9 babies is born prematurely, 1 in 10 in Canada. Worldwide, over 15 million babies are born too soon each year. While not all multiples are born prematurely, a multiple birth increases the probability of an early delivery. Babies born prematurely, before 37 weeks gestation, are at a higher risk for health complications in infancy, some of which can have long-term effects. Full-term infants are not all free from their own health complications, of course.

In honor of November’s Prematurity Awareness Month, led by the March of Dimes, How Do You Do It? is focusing this week’s posts on The Moms’ experiences with premature deliveries, NICU stays, health complications, special needs, and how we’ve dealt with these complex issues.

Leila and Rahul were born 2 months early, at 31 weeks in Hong Kong, where I temporarily moved a month before the birth, to access better NICU facilities.

At 29 weeks my contractions became more frequent, every 5 minutes. I was immediately hospitalized, for the 4th time during the pregnancy, given another round of steroid shots to speed up the babies lung development and put on a magnesium drip. The contractions were controlled at this fancy private hospital that didn’t have an NICU. So at 8am on Sunday morning, exactly 31 weeks gestation the doctor announced that I was in labour and had to be taken to the Queen Mary, a public hospital with an excellent NICU facility.

Rahul was low in the womb so a Cesarean section was risky. Leila was under my rib- cage and in a transverse position. A natural vaginal birth carried the risk that she might not turn head-down and an emergency C-section would then be needed.

Until then, my doctors had all been men who said I would need a C-section. That morning though, my husband Maher and I had to decide what to do on the spur of the moment, while I was contracting and in an emergency delivery setting.

The doctor on call was refreshingly a young woman who was insinuating that I opt for the natural birth. We didn’t have my blood-type on paper, so they couldn’t operate until they got the results. They drew blood soon after I arrived, late morning. They could not administer an epidural for the same reason. I secretly wanted to give birth naturally, and for the first time in the entire pregnancy I realized that it was possible, with risk of course, but we were accustomed to that by then. I felt I was in good hands. The efficient and natural way in which my case was being handled made me realise they did this often.

A sweet nurse called Angel held my hand through many of the growing contractions and Maher was by my side. I breathed in a gas mask, which would ease pain from the contractions. I remember frantically asking for Maher as I was being transferred from the ambulance stretcher that brought me in from the ambulance. I was wheeled through blue hallways, metallic elevators and ended up in the little delivery room. He wasn’t with me and I had no idea if he’d found his way.

He doesn’t speak a word of Mandarin, forget about Cantonese. The contractions were getting stronger, and longer and I didn’t realise that it wouldn’t be until 5pm that the babies would arrive. He made it. I relaxed a bit when as I saw him.

It was lunch time. The nurses insisted that he grab something to eat. There would be a wait before the delivery. My parents were waiting outside by then too. He took them down to the Starbucks that I would get to know very well over the next 6 weeks.

Between contractions Maher drew my attention to the view from a window next to my bed. It was beautiful. The afternoon sun was shining, the blue sea was glistening, and there was an island. The gas relieved some pain, but as the contractions became stronger I started to do bhramari (humming bee sound), and sheetali (sucking air in through a rolled tongue) breath work. It all came back to yoga, during the pregnancy and now. It was spontaneous. It kept me calm, grounded, and connected to a familiar practice. I used ujjayi breath all the time, contractions or not.

Just before 5 pm, I had fully dilated. The room suddenly filled up with nurses, doctors and two teams of paediatric specialists, one for each baby. Maher caught a glance of Rahul when he came out, right before he was rushed to the NICU. In the meantime a doctor was pushing on my belly to help baby 2 turn around. Another doctor had already given me an episiotomy and was ready to enter and manually turn Leila if needed. She turned on her own and was born 7 minutes after Rahul. She didn’t cry. There was some quick movement and maneuvering around her incubator for a few moments. They resuscitated and rushed her to the NICU.

A few minutes after all the delivery procedures ended Maher went up to the NICU to see our babies and to get some information about them. Only parents were allowed in during the visiting hours, 9am to 8pm. In the span of a few minutes, the room I was in went from being full of shouting nurses and doctors, to empty. I found myself alone, eating a bowl of rice and Cantonese beef or pork. I don’t remember which. There were two attendants who came in to ask which I didn’t eat – beef or pork. To them my brown skin automatically meant that I was either Hindu or Muslim. I asked for chicken.

The women then wheeled me to a room with thirty little cubicles separated by green plastic curtains. Each space fit a single, tiny bed and a little cupboard. I was to spend the next 3 days and nights there.

It was almost 8- o’clock, the end of visiting hours. My parents and brother-in-law who had just flown from Chengdu, made it in for a few minutes. They put my clothes, mobile phone, and whatever food they had on them in my little cupboard. I could reach for it from my bed. Maher came by for a minute with no news of L and R yet. The doctors were still preparing and assessing them and he hadn’t been allowed in. He rushed back to catch the 8pm deadline.

The attendant on duty who was changing sheets, cleaning the cubicles, handing over babies to their mums for feeds, and bed pans to others was not in a good mood, obviously bored and exhausted from her day in and out of dealing with new mums and their crying babies, and especially lacking patience for one who doesn’t speak Cantonese. I was exhausted but the adrenaline was pumping through my veins. My husband had seen the babies and sent me photos by SMS but they didn’t open on my phone. I spoke to family and friends. They were all upbeat and congratulating me. Maher was worried and I was reassuring him.

The room I was in was always awake, day and night, with the 30 mums trying to feed their babies, sleep, use the toilets and showers, and contain their excitement and pain.

A nurse came by to check my blood pressure. It was high as it had been for the last few weeks. I was not to leave the bed until early the next day. She also handed me a syringe and showed me how to express milk by massaging down on my breast, and then pushing in and down, but not squeezing. I slept for a few hours before I had to pump again, and then again. In the future I was to wash my hands thoroughly before expressing, clean the nipple and make sure the syringe was always in its wrapper. This I did every 3 hours that night, and for many months after. The nurse was surprised by how much colostrum I managed to express. Each syringe had to be labeled clearly and precisely with the date, time, and babies names, and then kept frozen until I could take them to the NICU in the morning.

The NICU story is a post on its own. After the stressful entrance into the world L and R are now healthy 4-year-olds. For almost a year now we’ve been living on Koh Samui, a magical island in Thailand. Living a dream.

Natasha is mum of 4-year-old fraternal twins Leila and Rahul. She moved to Koh Samui, Thailand with her children after spending 7 years in China. Her husband travels back and forth because work is in China. She has started practicing her yoga more regularly again, and even teaches a few classes a week, after a 3 year break. She blogs at her personal site Our Little Yogis and at Multicultural Mothering.

In the United States, 1 in 9 babies is born prematurely, 1 in 10 in Canada. Worldwide, over 15 million babies are born too soon each year. While not all multiples are born prematurely, a multiple birth increases the probability of an early delivery. Babies born prematurely, before 37 weeks gestation, are at a higher risk for health complications in infancy, some of which can have long-term effects. Full-term infants are not all free from their own health complications, of course.

In honor of November’s Prematurity Awareness Month, led by the March of Dimes, How Do You Do It? is focusing this week’s posts on The Moms’ experiences with premature deliveries, NICU stays, health complications, special needs, and how we’ve dealt with these complex issues.

My pregnancy had been difficult, to say the least. From 6 weeks on, I was beset with a very severe case of “morning” sickness, known as hyperemesis gravidarum. Despite medication, I vomited multiple times every day of my pregnancy (and, in fact, for about a week afterwards). Mr. A did not have a measureable heartbeat at our 7-week ultrasound, and measured very small. He developed a nice, strong heartbeat, but continued to measure behind. When I was 21 weeks, a follow-up anatomy scan revealed a complication, not with the boys, but with me: I had cervical funneling. I was put on bed-rest.

At 23 weeks, a high-risk OB doctor informed me that our Mr. A had fallen completely off his own growth curve, and had a very dim prognosis. The doctor said it was probably a virus, infection, or placental failure. He suggested either delivering between 24 and 26 weeks, or giving up on Mr. A. The panic and helplessness I felt still clutches at my heart. I felt so incredibly torn: why should I punish Mr. D by dooming him to a very premature birth, simply because he was a twin? But how could I give up on Mr. A? Whenever people say, “I always wanted twins!” or wish twins upon someone undergoing fertility treatments, I flash back to this moment, and think no, no, you don’t want twins, please hope instead for a healthy, singleton pregnancy.

It turned out, much to my joy (with a side-dish of pure rage), that Mr. A had no virus, no infection, no failing placenta, but instead an incompetent doctor. The ultrasound machines had switched to different software or something, and hadn’t properly calculated estimated gestational age, and the doctor didn’t bother to look at raw numbers before telling me this dismal news. I had multiple follow-ups at different offices, plus a ton of blood work, and everything was fine. Mr. A was small, but doing just fine.

The weeks crept by, and I remained pregnant. I was even briefly off bed-rest, for 3-week span that included Christmas. I was, however, having very regular contractions. I had non-stress-tests twice a week, and after each one, they wanted to send me to L&D. But my funneled cervix was holding fast, so I remained on bed-rest and carried my boys all the way to my 35th week, much to the amazement of myself and my OB. I was having ultrasounds every 3 weeks to monitor Mr. A’s growth, and he was holding steady on his own curve, with Mr. D riding along at about the 50%ile.

On Tuesday, January 31st, I went in for another NST. My husband happened to have that Tuesday off, and so he came with me. My boys, especially Mr. A, gave the nurses fits at each NST, refusing to stay still for the required 20-minutes of continuous monitoring, stretching these tests into hours-long events. On this day, Mr. A was so wiggly that they decided to simply to a biophysical profile on him instead, and throw in some growth measurements for kicks.

They never got that far. The ultrasound showed Mr. A hadn’t grown in 10 days. He had, according to their measurements, actually shrunk. (I do know that babies do not grow shorter, but they can lose weight. We suspect this is what happened to Mr. A.) More alarmingly, the his umbilical cord was showing reverse blood flow. Mr. D was doing great, but my husband and I were pretty sure we knew what was coming.

But first we had to wait. The tech could not say, “These babies are coming out.” Even the high-risk OB would not say, “Today is the day.” I was sent to my regular OB’s office, where we waited. In the mean time, I called my younger sister, who is an OB in a different state, and left her a voicemail explaining what was going on. And my mother called me, and so I told her as well. About 4 hours after my NST should have been, my OB sat down with me and my husband, and said that she would schedule a c-section for 5 pm, so not to eat or drink. I had very much wanted a vaginal delivery, and she was even willing to perform a breech extraction, but with both my boys being transverse and with my lower baby being significantly smaller than my upper baby, that was off the table. I had kind of seen this coming, and really, the bottom line of my birth plan was “everyone out, alive”, so c-section it was.

The following 2.5 hours were very strange. We went home, I packed a bag and took a picture of my pregnant belly. My husband went to his office to finalize his FMLA. I watched an old episode of “The Daily Show”, thinking, “This will be the last time I sit on this couch without a baby in my house.”

I was wrong about that. While plenty of 35-weekers do indeed come home from the hospital with their moms, with little to no NICU stay, such was not to be the case for my boys. I had gotten beta-methasone shots to mature their lungs about a week prior, so I did have reason to hope. However. Mr. D had what is known as “wimpy white male syndrome”—he just did not do as well as girls or babies of other races would do. Mr. A turned out to have a very rare chromosomal abnormality, and would have needed extensive NICU time even if he had been full-term. I believe with all of my heart that the only reason Mr. A survived at all was because he was a twin. If he had been a singleton (as my current pregnancy is proving), I would not have had cervical funneling, extensive contractions, multiple ultrasounds because they simply couldn’t see Mr. D’s diaphragm or Mr. A’s kidneys due to positioning, etc. My OB-sister thinks that perhaps they would have noticed that my belly was measuring small, but frankly I am not convinced. Of course, if Mr. D had been a singleton, he would very likely have been full-term. Thus I think both my boys were in the NICU solely due to being multiples, but that Mr. A would not have made it that far if he were not.

But dreams about my future eventually gave way to reality, and we left for the hospital. My mother met us there. My husband and I had agreed that his job was to stay with the babies, and my mother felt that it was her job to stay with me.

They monitored the boys for a bit, then wheeled me into the freezing OR room. The room was teeming with people: a full NICU team for each baby, my OB and her partner, the anesthesiologist, a few nurses, and a medical student who got the fun job of holding the little tray while I vomited into it. I have always reacted poorly to medications of any sort, and the spinal and morphine and whatever else they used was no different. My husband came in, dressed to impress in sterile gear, and held my hand while they made the incision. There was a lot of tugging, which felt very odd. Mr. A was really wedged into my pelvis, and extracting him was difficult. But I heard them say, “Here he is!”

Someone—probably a NICU doctor—showed me my firstborn for less than a heartbeat. I was not allowed to snuggle him as I so longed to do, but I could clearly see why: he was a very scary shade of grey, and not crying. “He looks so blue!” I exclaimed, but no one answered. “Will he be ok?” Then I heard a weak cry, and began to sob myself. He would, he would be just fine.

And then, “5:31 pm, Baby B”…and I saw my Mr. D. They let me kiss him. I heard them call out Mr. A’s weight—3 lb 12 oz. That was 6 ounces less than the estimate, but I couldn’t dwell on that. He was 17.25 inches long. They took Mr. D and weighed and measured him: 6 lb 2 oz (exactly as estimated) and 19.5 inches. A’s APGARS were 6 and 7, D’s were 7 and 8. I think they would have let me spend more time with Mr. D, but my Mr. A needed to go to the NICU, as he was having a very hard time breathing and clearly needed surfactant and intubation (not that I could see this, as my OB was still mucking around in my uterus, extracting placentas and massaging blood out and whatever else goes on). My husband left with them, as did my heart.

I was sewn up and taken back to recovery, where things did not go well. I continued to vomit, and began shaking uncontrollably. The nurse seemed unphased, but my mother was very worried, I was I. My husband returned briefly to show me pictures of the boys, then left again. A neonatologist stopped in to give me news I couldn’t yet process: Mr. A had a cleft palate and was doing much worse than he should be. I just wanted to be with them, to see my boys, to hold them, to kiss them. I was eventually taken to a room on the floor, shaking less but still vomiting. I was told I couldn’t see them until I could walk from my bed to the wheel-chair unassisted. They would not even let me attempt this until 5 hours after their birth. When they did, I feared I wouldn’t make it. I believe I walked those 3 steps on will-power alone.

I was wheeled into the NICU, and saw my beautiful sons laying in adjacent open warmers. Mr. D had an IV in his scalp and an NG-tube down his nose, and all the monitoring devices, but no oxygen. I was allowed to hold him for a few minutes. I cried the whole time, at the love I felt for my beautiful son. Mr. A was on an oscillating ventilator, had an umbilical IV and an arterial line in his right arm, an I was not allowed to hold him until his fifth day of life. But I cried to look at him, out of love.

I did not feel a “completion”—a sense of “now I have my babies”, an ending to a birth story. I never really did. I suppose it truly ended 62 days later, when both of my sons were finally home from the NICU, and I was able to hold them both in my arms. It was a very long journey, but worth every minute.

In the United States, 1 in 9 babies is born prematurely, 1 in 10 in Canada. Worldwide, over 15 million babies are born too soon each year. While not all multiples are born prematurely, a multiple birth increases the probability of an early delivery. Babies born prematurely, before 37 weeks gestation, are at a higher risk for health complications in infancy, some of which can have long-term effects. Full-term infants are not all free from their own health complications, of course.

In honor of November’s Prematurity Awareness Month, led by the March of Dimes, How Do You Do It? is focusing this week’s posts on The Moms’ experiences with premature deliveries, NICU stays, health complications, special needs, and how we’ve dealt with these complex issues.

Back when I was in my first trimester, pregnant with our twins, I wrote on here asking other MoMs how I could still work with a midwife and try to have a vaginal birth after being told that I needed to see an OB and deliver in the OR. Some of the feedback I received was to accept what I couldn’t control. I fought this at first, of course. But eventually, I realized that the only thing I could control at the time was my attitude toward the situation. I decided to take this advice and surrender to the experience of being pregnant with twins.

I’m so thankful I did. Accepting what I did not have control over, deciding to trust my doctor and do everything in my power to remain calm was what got this previously terrified patient (and perhaps control freak?) through the crazy end of a twin pregnancy. While I, like every other birth story on here can say it did not go as the way I’d always hoped to give birth prior to getting pregnant, I can also say that, despite having many things go “wrong” at the end of a pregnancy, it’s still possible to have a really amazing experience. I really do attribute this to the rock bottom expectations I had around giving birth and just knowing that I wasn’t calling the shots.

My “birth” story probably really starts at 32 weeks when, after a pretty healthy twin pregnancy, I was sent to labor and delivery at my 32 week appointment. My doctor (now the OB I’d grown to trust) was concerned about my blood pressure, my ginormous feet, and some pre-term dilation. Somehow I knew that the babies were not coming that day, however. We spent two nights on the high risk floor, so that I could receive some steroids for lung development and a drug to stop the contractions. I was then put on bed rest for the next 10 days to get me to 34 weeks, which is when the doctors felt more comfortable with me delivering. Ten days later-no babies. So, I was allowed to return to work.

I was there for one day, and then sent home after I had protein in my urine at my next appointment. Back to bed rest until a preeclampsia diagnosis could be ruled out. 24-hour urine collection at home, loads of fun. And back to the hospital at 34 weeks and 5 days for my ever-increasing blood pressure. Another two nights in the hospital after my platelets were low and the doctors wanted to rule out HELLP syndrome. Another urine collection reveals a preeclampsia diagnosis-what the doctors were waiting for. The night before my 33rd birthday, an IV was started and I was told to fast, in preparation for surgery. (Our son, baby “A”, pretty much sat cross-legged, breech, for my entire pregnancy, and I’d, by this point, accepted a c-section.) I spent my birthday eating ice chips, waiting for the perinatalogist to approve a pre-36 week delivery, and after 18 hours, the doc finally shows up and gives the thumbs down. She wants me to stay in the hospital for another week, to get to 36 weeks.

Oh, hell no. There is no way I am spending another two nights on the high risk floor, then another seven laying here waiting for 36 weeks, then another four nights after a c-section. Only to return home and not sleep for the forseeable future. Not to mention, it took you 18 hours to tell me this?! (Those of you who have spent multiple nights in the hospital know how little they let you sleep while you’re there. During my first stay I was woken up at 3am so they could WEIGH me.) Ready to check myself out AMA, my own doctor fights for me to be on strict bed rest at home, checking my blood pressure multiple times per day, and coming in for monitoring. Deal. I can do that. Multiple close calls over the next week, but I make it to 35 weeks and six days.

Delivery

(My husband got up and went for a run at 4:30am the day of my surgery. He ran. I definitely appreciate the need he had to burn off nervous energy and somehow commemorate the day with a jog to the beach to watch the sunrise on the day our babies were born. But, I still find the irony hilarious: I hadn’t been able to walk more than the distance to and from the couch/bathroom in a month, and he went for a lovely early morning run. Love you, dear.) Everything was clockwork once we arrived to the hospital-well-oiled machine, despite my anxious tears throughout the entire pre-op process. Many of my fears were knocked down. Fear of going into labor and not getting the doctor I wanted? My doctor came in on her day off to do my surgery (and I could canonize her for this!). Fear of a bunch of old, male doctors who would be insensitive? Of the 17 or so doctors, NICU nurses, etc. who came in and out of the OR that morning, only two were male, and all 17 were great. Fear of throwing up on the table? My iron gut served me that day.

Things that are clear in my memory from the surgery: telling the anesthesiologist resident that I needed her to hang out right next to my head. Telling my doctor to distract me during the spinal with stories about the country concert she’d taken her daughter to a few days before. My husband getting to cut the cords of both babies and telling me our son “has dark hair like you” and our daughter is “light like me” with tears pouring out of his eyes. Asking my husband to take a photo of me on the table so that I had proof that I was there. Telling the OR staff to call our children by name and me Katie (as opposed to Katherine) so that I felt more comfortable throughout the surgery. The tilt of the operating table, supposedly to help bring blood pressure down. Not feeling pain until the very end when the docs pushed on my stomach to get blood clots out. Ouch.

Recovery

The previous hospital stay where I received steroids proved useful, and our son only needed to be in the NICU for one night and our daughter for two. We knew what an incredible blessing this was! I was put on a magnesium drip shortly after surgery, while we hung out in the post-anesthesia recovery area. Within minutes of starting the IV, I could barely finish a sentence without falling asleep. My husband still likes to tell the story of me, drugged up, while another woman was wheeled in right next to us, and gave birth after about ten minutes, unmedicated, as they were using the area as triage, so close to us, my husband could have caught the other woman’s baby. The first 36 hours or so were rough. Even though I was hell-bent on being the first person to hold our babies, and the NICU staff obliged, I was too drugged up from the magnesium drip to really know what was going on. I absolutely relate to another post on here about feeling out of place, as I watched our family come and go to the NICU with my husband. I kept saying I felt like I’d been in a car crash and was all beat up, but everyone else was celebrating and telling me about what my babies looked like. It was such an out of body experience. The pain was pretty awful during those first two nights, as well. It was absolutely traumatizing to go through such an experience and have my babies away somewhere, while others are able to go off and visit them, while I was groggy, in bed. I remember having dreams that people were sitting on me, pushing and pulling on my body. I had to ask anyone in our room to talk softly. It felt like sensory overload.

By the time the babies were released and were able to stay with us in our room, things had shifted dramatically. The nasty magnesium had finally made its way out of my system, and was able to do some skin-to-skin time with each of them and completely fell in love with my little babies. I still, 16 weeks later, feel like it was an out-of-body experience, and am oddly grateful to have a c-section scar to validate that I was there. I feel profoundly thankful that our babies were healthy, that I was able to conquer a boatload of lifelong fears about giving birth and that despite the drama of the previous month, things never escalated to emergency status. It was amazing to meet our son and daughter on the outside.

In the United States, 1 in 9 babies is born prematurely, 1 in 10 in Canada. Worldwide, over 15 million babies are born too soon each year. While not all multiples are born prematurely, a multiple birth increases the probability of an early delivery. Babies born prematurely, before 37 weeks gestation, are at a higher risk for health complications in infancy, some of which can have long-term effects. Full-term infants are not all free from their own health complications, of course.

In honor of November’s Prematurity Awareness Month, led by the March of Dimes, How Do You Do It? is focusing this week’s posts on The Moms’ experiences with premature deliveries, NICU stays, health complications, special needs, and how we’ve dealt with these complex issues.

The first day I was a mother, I believed that I had already failed in the role.

Unable to get pregnant without the intervention of science, and unable to give birth without the doctors cutting me open and extracting the babies, my one job as an expectant mother had been to keep my twins nestled firmly and warmly in my womb.

At 33 weeks, I began preterm labor due to preeclampsia. When the decision was made to have an emergency c-section, I burst out sobbing. I had always been healthy; never had any hospitalizations; and, I really believed that the issues facing my pregnancy were ones that happened to other people, not to me.

In my mind, I had somehow failed my one, and most important, job.

After being bundled tightly in their blankets and posing for a quick picture in front of my head, Marc (4.5 pounds) and Maddie (3.4 pounds) were rushed to the Neonatal Intensive Care Unit.

Under the ominous, and yet miraculous for women with preeclampsia, drug, magnesium, I was unable to get out of my bed or even see my babies for over 24 hours. I remember waking up the next morning in a horrible magnesium fog and not remembering what we had named our daughter. When one of the neonatologists came into to my recovery room to report that Marc’s lung had collapsed and he needed to be intubated, I couldn’t process what she was saying and I couldn’t remember my husband’s cell phone number to tell him to come to the hospital. The failures seemed to continue to pile up.

Even when I was able to see the babies, I felt so disconnected from them. I wasn’t able to hold them—or do anything for them. I felt like an outsider—like it didn’t really matter if I was their mother or not. I remember telling Scott that the babies were more his than mine. He had spent more time with them; he had already developed a rapport with the nurses; he seemed to know what was going on.

Those first horrible days were nothing like what I had imagined their birth would be like. Without family around or a mothers-of-multiples support group, no one was able to help me navigate through those feelings of overwhelming guilt, helplessness, and disconnect that accompanied those days.

And, while the emotional rawness of that time has been smoothed away, the trauma of those first few days still resonates with me. When I asked moms in my San Antonio Mothers of Multiples group what their feelings were when their babies where in the NICU, I was surprised at the emotion that erupted, even from mothers whose children were now in their teens.

Out of control or helpless: Christina, mother to b/g twins described feeling out of control, “…like I was a nuisance for wanting to come and nurse him and hold him.” The mother often feels like she takes back seat to caring for her babies.

Mourning the loss of the imagined delivery: We all imagine how the birth of our children will occur. When it doesn’t go like that, there is an incredible sense of loss or disillusionment. In some way we feel we were cheated out of a genuine experience. One mother, whose twins were born at 27 weeks, 5 days wrote, “I don’t know why I assumed that I would have the birth I wanted—naturally at 38 weeks and they would be fine and healthy and go right home with me.” She writes that even a year later, “I still feel cheated from the whole new mom experience—I didn’t get to hold any of my babies after they were born; I didn’t see them until hours later; a nurse gave them their first bath; their first bottle.”

Shock: “It was only on delivery day that anyone even started talking to me about the NICU and that they would have to go there…the first time I went in there was a few hours after delivery. It was just bizarre. All those teeny tiny robo-babies hooked up to various machines and wires.”

Relief: A couple of moms wrote that they were relieved that their babies were in the NICU. “I was in no condition to take care of my babies,” wrote one mother of twins. “I needed to heal myself, and I knew they were in good hands.”

Guilt: Almost all of the mothers expressed feelings of guilt, constantly reexamining what they might have done to have caused premature births or birth defects. Sara, a mother of b/g twins whose daughter was born with her esophagus from her throat growing nowhere and her esophagus from her stomach growing into her trachea, wrote,“Some days I could emotionally handle seeing her attached to what seemed like a bazillion tubes and listen to the breathing stridor; some days not. Once I came out of the morphine/Vicodin induced haze [from her C-section], I started wondering what I did wrong, reading medical journals about when that particular defect manifests itself. Then, I started wondering if it was because, before I knew I was pregnant, I had a margarita in an airport around 11 am and had a daiquiri that night around 8 pm… On an intellectual level, I knew it was not my fault.”

Powerless: A couple of mothers talked about how difficult it was to get their babies out of the NICU.One mother wrote how, “you can’t be blind to the reality that all pregnancies and births have risk and sometimes babies that seem to be perfectly normal may need some extra help from the NICU.” She goes on to write how important it is to have “… an advocate, whether that is a doctor, family member or friend who will help you fight for what you believe to be right.”

Did you have these feelings when your multiples were in the NICU? Other feelings?

In the United States, 1 in 9 babies is born prematurely, 1 in 10 in Canada. Worldwide, over 15 million babies are born too soon each year. While not all multiples are born prematurely, a multiple birth increases the probability of an early delivery. Babies born prematurely, before 37 weeks gestation, are at a higher risk for health complications in infancy, some of which can have long-term effects. Full-term infants are not all free from their own health complications, of course.

In honor of November’s Prematurity Awareness Month, led by the March of Dimes, How Do You Do It? is focusing this week’s posts on The Moms’ experiences with premature deliveries, NICU stays, health complications, special needs, and how we’ve dealt with these complex issues.

Once J and M were born at 33 weeks gestational age, they were whisked off to the NICU. I have to admit that my memories are fuzzy and I wasn’t there for the first day and a half, having just undergone a C-section. In this post, I’ll describe my impressions of our 3-week residency of the NICU. I’m not referencing medical records for this post. This is all mommy memory.

On the Outside

I’d run a fever after the C-section, so I wasn’t allowed to visit the NICU. Even after the fever abated, I was told, I’d have to wait 24 hours before I was cleared to visit the NICU. I had a major meltdown when a nurse had implied that the drops of colostrum I’d finally managed to pump weren’t worth transporting to the NICU. After all, pumping was the only maternal duty I could perform. I was a crying wreck and found myself starting to feel increasingly distant from the whole situation, as if I were watching everything from 3 feet above my body, as if the birth had never happened.

I’d asked my husband and in-laws to watch me for signs of postpartum depression, and my mother-in-law gently, but firmly, pressed my phone into my hand and told me to call my therapist. We had a session over the phone. I poured my heart out: the feelings of failure and powerlessness surrounding the preterm birth experience; the fear that I would never have truly maternal feelings toward these still theoretical children; the greater fear that M would die; the surreal fear that I would enter the NICU and have no idea which children were mine; the practical concern that I would exhaust my maternity leave before my children ever came home; the jealousy I felt toward my husband and mother-in-law for being allowed to see the babies. My therapist–the same one who had walked me through my past toward peace, even excitement, about being a mother–validated my feelings, helped me feel that they were normal and transient. She grounded me.

My NICU story started well before I ever entered the NICU.

Entry

My husband knew that I needed to see the children, for their well-being and mine. He refused to take no for an answer and finally found someone to permit me to see my children as long as I wore a surgical mask in the NICU. I balked, fearing that my needs would endanger our children. He insisted and I was too broken to press my point.

I transferred from the bed to a wheelchair, which did not feel good a day after I had been cut open, my womb cleaned out, and then sewn back together. My organs were still finding their places around my much reduced womb. I was wheeled into the NICU and had to stand (OUCH) to scrub in. I felt another twinge of jealousy as my husband scrubbed expertly up to his elbows and under his nails while I tried to follow the directions on the wall. I had no idea that the smell of that soap would return me to these memories every time I encountered it again.

I first saw my girls when they were 36ish hours old. I’d seen Polaroid images of each of them, as well as photos on my friend’s phone, but I wasn’t prepared for how truly tiny they were or all the wires and tubes and machinery. The beeps and dings and whirs coming from all around the room were overwhelming. I was deeply thankful for the name tags; I wouldn’t have been able to identify my daughters without them.

This was how I first saw my little M.

My husband explained to me what each sensor did, but nothing stuck. A nurse asked me if I wanted to hold the girls. It hadn’t occurred to me that I’d be allowed to, so I just stuttered. I honestly didn’t remember which child I held first until I looked back at my photos just now. My second born M was the first in my arms.

I remembered to be surprised that weren’t placed in the same open warmer. I remembered reading that multiples do better in the NICU if they’re allowed contact with each other. The hospital had recently changed their policy, I was told, and no longer co-bedded multiples. I was annoyed.

In the NICU

It took no time at all for us to get into a routine. Apart from a period several times a day when doctors did their rounds, parents could stay in the NICU at their child’s side. My husband and I were each given wrist bands that permitted us entry into the secure facility. We could each bring a maximum of one visitor at a time to visit the girls, since technically we could have two visitors per child.

Every three hours, our children were tended by the nurses, first M then J. Their diapers were changed and weighed. We were allowed to help with that. The babies were weighed twice a day. They were fed a mixture of high calorie formula and whatever milk I could produce, by a tube threaded through their noses into their stomachs. My husband gavage fed them, but I never learned how. Neither of us was keen on pricking their feet to gather a blood sample; we left that task to the nurses. We took their temperatures, though. The NICU nurses sent us home with their individual thermometers. I used those things until they were over 4 years old.

We considered taking advantage of the nearby Ronald MacDonald House, which allowed parents of sick children to stay near the hospital. We only lived 30 miles away, though, it seemed wrong for us to take a spot that could be better used by parents who lived farther. The maternity ward was kind enough to let me stay in my room, left to my own devices for food, of course, for several days after I was officially medically released.

I ripped out my staples a couple of times walking down the hall to the NICU, but no one and no pain was going to keep me from my kids.

On the second or third day after birth, our nurse encouraged us to provide kangaroo care to our girls. My husband unbuttoned his shirt, leaned back in his chair, unwrapped J from her swaddle and buttoned her snugly against him, chest-to-chest. I pulled open my tank top and did the same with M. She wiggled herself into a comfortable position and fell asleep. J had other ideas. She squirmed and wriggled and twisted until she’d pulled herself up Daddy’s chest and was nestled under his chin. We sat like that for hours until it was time for their heelpricks and feedings. I knew that I was serving the same purpose as the open warmer, one of the purposes I’d served during my pregnancy, keeping little M warm. I felt like her mom for the first time, and it was great to share that feeling of growing a human with my husband. He kept poking me to ask whether I’d seen his rock star of a precocious preemie climb up him. Had I really seen it? That was his girl. My husband was as proud of J in that moment as he was at the only one of her ballet recitals he was able to attend, 5 years later.

When our girls were a few days old, I was telling my nurse Michelle how surprised I’d been by their cobedding policy. She asked if I had any photos of the two of them together and was shocked when I said no. She looked around furtively and then grabbed the camera while my husband held one baby and I held the other, surreptitiously and briefly reunited. M had just pulled her feeding tube out again.

A few days later, both our girls were moved from open warmers to closed isolettes. I could no longer sit between them and place a hand on each of my daughters. A few days further along, we were given a private room within the NICU, just for our pair, away from the sounds of the machines monitoring the much sicker babies.

We were told that our babies were feeder-growers. There wasn’t anything functionally wrong with them that couldn’t be attributed to their small size. They simply needed to feed and grow. There were four criteria to be met so we could take them home. They needed to be able to take at least 31 mL (1 oz) of nutrition by mouth 8 meals in a row. They needed to weigh 5 lbs. They needed to be able to maintain their body temperature without a warmer or kangaroo care. They needed to pass the car seat test.

We had a constant reminder of how fortunate we were. There was a little boy across the NICU aisle from our girls, a 4-month-old. He would never leave the NICU alive. The alarms that indicated dangerously low vitals went off several times a day. His parents couldn’t even visit daily any more. They’d had to return to work. I thought about the little boy on hospice care often, even after the girls were home.

Once bottles were introduced to my daughters, somewhere before the one-week mark, M was a drinking pro. J was tougher to feed. She’d get distracted, toying with the nipple in her mouth instead of suckling. I was only allowed to breastfeed M, and that, only once. My milk had already come in; I was a slave to the breastpump. A lactation consultant came to the NICU and helped me work on my latch. I couldn’t believe she expected my entire areola to fit in her mouth; my breast was twice the size of her head! (It didn’t fit, in case you were wondering. Not completely.) Let down was so beautiful, not the mechanical and slightly painful mechanical action of the pump. Just as I felt like M and I had it down, it was time for me to learn how to break the latch with my comparatively enormous pinkie. Nursing was using too many of the calories that needed to go to growth.

At one point, after several days of oral feedings, J had to have her feeding tube reinserted. She just wasn’t getting enough calories orally. It was the first time during the entire ordeal that I saw my husband cry. The NICU was all two steps forward, one step back. They’d gain weight and then stall. They’d stay warm, then begin to run cold again. J would feed orally, then forget. And we had it easy: no apnea, no bradycardia, no jaundice. The other babies in the NICU were always there to remind us how much worse it could be.

We’d been told not to expect the girls home before their due date. That would leave me only 4 weeks of maternity leave to establish our routine before I had to go back to work. I began to talk about going back to work as soon as my doctor released me so I could maximize my time at home. A nurse took me aside and told me not to go down that road. The girls were doing so well that they’d be home long before they reached 40 weeks gestational age.

At one point, the hospital staff asked if they could transfer J and M to a lower level NICU at a different hospital closer to our home, freeing up beds for sicker kids. We were all for it until it was time to sign a waiver excusing everyone of responsibility for our kids during transport. We refused to sign; we saw another family signing the paperwork a few hours later.

At one point, my husband noticed that all the neonates had Spanish last names “except the twins;” there was another set there. I pointed out that our last name was Rodriguez. Even though he didn’t consider himself Hispanic and I was South Asian, our family still fell in the Hispanic camp. We asked the nurses about it, and they said that they thought the demographics of the NICU were connected to the availability of prenatal care in the poorer Hispanic population of South Austin.

When the girls were almost 2 weeks old, we got the news. They were out of the woods. We were just waiting for them to achieve the magical 5 lb weight so they could go home. My husband told his commander in the army. He was immediately ordered to California for pre-deployment desert training. They could spare him for the 14 days of his paternity leave, but if our kids were out danger, that was all he got. His mom drove him to the airport. I stayed at the hospital with our babies.

One Baby Home

When M was 16 days old, my father-in-law drove us home from the NICU. I didn’t expect her to be released with such little fanfare. I had no idea she was doing so well. I was still recovering from my C-section and wasn’t cleared to drive. We left J all alone. I didn’t know whether to celebrate or grieve. I felt horrible leaving J, regardless of how much I trusted the nurses. I thought that the birth experience had ripped my heart out, but I now felt true agony.

On arriving home, I immediately began to breastfeed M, supplementing her feedings twice daily with high calorie formula from a bottle. Every drop I pumped, I delivered to the NICU for J once a day. I couldn’t spend more than 10 minutes with her; little M was waiting in the parking garage with Grampy, since non-patient children weren’t allowed in the NICU.

I tried to be positive. I figured M was missing J more than I possibly could.

Together

After the 5 longest days of my life, J took 8 31-mL feedings in a row. She was allowed to come home. Both kids were doing so well that the hospital waived the 5-lb requirement to free up beds in the NICU. Daddy came home from California about 3 weeks later. Until his deployment another 3 months from then, our family was complete.

As soon as I placed the babies side by side, before Daddy got to come home, they stretched and rooted and wriggled and wiggled until they were pressed up against each other. Each raised one hand above her head, firmly grasped her sister’s hair, and fell asleep. At age 7, they still sleep snuggled up like that, minus the hair pulling, unless they’ve been arguing. J prefers to sleep on her belly, M on her side, but I insisted they stay on their back as newborns for fear of SIDS.

Our NICU story was over, but I was painfully aware that all but one or two of the babies who were in the NICU the day my girls were born were still there. They had a much rockier road ahead than my tiny pair.

For comparison, here’s a photo of J and M at age 7, with the same blanket that they were on at 21 days old.

Sadia (rhymes with Nadia) has been coordinating How Do You Do It? since late 2012. She is the divorced mother of 7-year-old monozygotic twins, M and J. She lives with them and their 3 cats in the Austin, TX suburbs and works full time as a business analyst. She retired her personal blog, Double the Fun, when the girls entered elementary school and also blogs at Adoption.com and Multicultural Mothering.

In the United States, 1 in 9 babies is born prematurely, 1 in 10 in Canada. Worldwide, over 15 million babies are born too soon each year. While not all multiples are born prematurely, a multiple birth increases the probability of an early delivery. Babies born prematurely, before 37 weeks gestation, are at a higher risk for health complications in infancy, some of which can have long-term effects. Full-term infants are not all free from their own health complications, of course.

In honor of November’s Prematurity Awareness Month, led by the March of Dimes, How Do You Do It? is focusing this week’s posts on The Moms’ experiences with premature deliveries, NICU stays, health complications, special needs, and how we’ve dealt with these complex issues.

Despite the reams I’ve written about motherhood over the years, I’ve never sat down to write my daughters’ birth story in its entirety. When they were newborn, I was too busy and it was too raw and painful. Later, every time I thought about blogging about it, I chose not to, fearing that I would frighten expectant mothers with my horror story. I just said, “They were born by emergency C-section at 33 weeks,” and left it at that.

It’s not a horror story, though. In the end, my daughters are okay. They’re fantastic. They’re happy, healthy and whole; funny, sassy and smart; loving, considerate and goofy. Sure, I have my scars, but I have never felt the grief of losing a child or the very different grief that a child’s special needs will limit her options in life. It could have been so much harder.

The Pregnancy

I had a remarkably uneventful pregnancy, especially considering that I was carrying identical twins. I was tired, of course, and ate enough to feed a small family. I was eating for a small family, come to think of it. Other than that, though, I felt great. I had no morning sickness. I threw up once, but it was because the tap water in our new house was nasty. I did start having pretty severe Braxton Hicks contractions around 30 weeks, made worse if I allowed myself to get dehydrated.

I looked full-term at 31 weeks, but felt great.

My mother-in-law threw us a baby shower in Oregon, but my doctor strongly recommended that I not travel past about 25 weeks, so I stayed in Texas. At 31 weeks, my obstetrician recommended that I stop working the following week. In my great wisdom, I instead elected to work half-time, working from home 3 days a week and coming into the office twice.

My husband and I took our Lamaze class early, with other expectant moms two months closer than we to their due date, but I still never really considered the reality of the chances of our girls being born early. After all, the triplets in our family were born at 38 weeks! In fact, while I’d made my packing list and assembled the girls’ cribs by 30 weeks into the pregnancy, I didn’t pack right away and didn’t think anything of my soldier husband leaving for a week-long field problem in the wilds of Ft Hood when I was 32 weeks along.

The Babies Are Coming!

My husband returned home from his wilderness field problem, delighted to trade in his sleeping bag for our bed. My pregnancy was at 33 weeks. He was exhausted from having been in the field and I was exhausted from growing babies, so we went to bed early.

At 1:22 am, I was woken up by a cold wetness in my bed. I instantly knew that my water had broken. Later, I learned that only J’s water had broken. My babies were mono-di; their shared chorion had ruptured, as had J’s amniotic sac, but M’s amnion was still intact.

I woke my husband. He started mumbling about car seats and I realized that I was going to need to take control of the situation.

“It’s too early,” I told him, more calmly than I felt. “They won’t come home with us. We need to get to the hospital. Bring the insurance stuff and some books for me to read. You can come home for everything else.”

We called our doctor, who told me to use a maxi pad to catch the constant leak between my legs. On the drive to the hospital, I called my mother-in-law. She immediately started looking into airplane tickets to fly from Washington state to Texas.

The First Hospital

We had preregistered at our local hospital, so I went right into the maternity ward. The nurses took my maxi pad away to test it. While we waited, I changed into a hospital gown and my contractions started. After what seemed like an unnecessarily long time, a nurse returned to inform us of what we already knew. It was amniotic fluid and I was in labour.

The doctor on call at our suburban hospital told me that he was going to recommend that I be transferred to another hospital, Brackenridge in Austin. At the time, it was connected to our local Children’s Hospital and the best NICU around. Even though Brack wasn’t part of the hospital network we’d arrived at, our ob used to have privileges at Brackenridge and pulled strings to get an ambulance to transport us across hospital networks. There was no chance of the natural vaginal birth I’d hoped for. Both babies were breech.

“I would rather these babies arrive at the NICU inside you than after birth,” I remember the on-call doctor saying. “You also want to recover from your C-section in the same hospital they’re at so you can see them.” I wish I remembered his name. He was so kind.

My labour was progressing much too fast. My contractions were hard and fast but I was hardly dilated. While they arranged for the ambulance, they started me on a magnesium sulfate drip to slow my contractions. They also inserted a urinary catheter. They asked me if I’d be okay with a trainee nurse performed that procedure with an experienced nurse overseeing her. I agreed. I’m fully supportive of educational opportunities, but it did hurt.

The Ambulance

When the ambulance was ready and the paperwork done, everything happened very fast. I was rolled out into the ambulance bay on my bed, and tried to yell directions to Brack to my husband when I realized he’d be driving behind us. My impressions of the ambulance were of bright lights, sirens, bumps, increasingly painful contractions and a kind nurse with warm hands who tried to distract me from my contractions with questions about my hopes for my daughters.

Getting Settled at the Second Hospital

I later learned that my husband got lost on his way to the hospital. He called his mom in Seattle to get online and find him directions in Austin, Texas. She still marvels at the wonders of technology that early morning of May 10, 2006.

The on-call doctor came in and introduced himself, telling me that I was going to have an emergency C-section. I asked if there was any way to just deliver Baby A and leave Baby B in to gestate longer. He just said no and asked for me to start getting prepped for surgery.

The nurses checked how I was doing. They reported high protein in my urine and became alarmed. There was a rush of activity and a nurse came to see whether I had dilated any farther than my last measly 1 cm, reported at the first hospital. She went silent and I got scared.

They removed the catheter from my vagina. It hurt, far more than my full-bladder contractions. Once they got everything in the right place, the contractions became almost comfortable. I later learned that I’d been at risk of bladder rupture, thanks to the first hospital’s mistake.

They started my epidural. I’d be going under the knife awake, my lower body numbed. I was started to worry that my husband wouldn’t arrive on time.

The Delivery

He arrived just as I was being rolled into the operating room. I confess that I was too scared to notice much of what was going on. There were people in scrubs everywhere. They threw up a curtain across my body and strapped down my wrists. I remember thinking, “No, this isn’t supposed to be how they enter the world. This is all wrong.”

The doctor asked if I could feel anything below my waist. I could feel him pressing, I told him. He started to cut. Fortunately, all I felt was pressure. I was scared, but my husband was holding my hand. He was fascinated by what he saw on the other side of the curtain.

“J’s here,” he told me suddenly. I heard something that sounded like a kitten meowing. Her Apgar score was 9. I saw a flash of black hair and she was gone to the NICU. My husband was holding my hand again.

Splash. My husband guffawed.

“They punctured M’s sac and she splashed all over the doctor. That’s my girl,” he said proudly.

I heard more meowing, drowned by a delivery nurse’s urgent whisper. “There’s something wrong with her face!”

Her Apgar score was 8. One wrist was unstrapped so I could stroke her hair and then she was gone. I urged my husband to follow her to the NICU, but he reminded me of our agreement to let him stay with my until I was sewn back up. As soon as the last staple was in, he disappeared.

The First Day

I lay in my recovery room. It was 6:45 am and I was a mother who couldn’t do a thing to parent her own children. I waited until 8:00 and called my coworker Dustin to tell him that I wouldn’t be at our morning meeting… or any meetings at all for a while. I later learned that he took the brunt of our female coworkers’ wrath, since I failed to give him the girls’ birth statistics and he failed to ask.

A nurse came into check on me and deliver a hospital breast pump. She told me that my husband had been very forceful in his insistence that I be given every opportunity to breastfeed. I looked at the pump equipment and figured out how it fit together. I started pumping, as I would do every 3 hours without fail for the next weeks that my daughters were in the NICU.

I began to regret having told my husband to stay with the babies. I wanted to know how they were doing. The recovery nurse promised to ask. Soon, our friends Kaylan and Markus arrived. Kaylan was horrified that I hadn’t seen any photos of the babies yet. She marched off to the NICU and returned with two photos on her phone.

Our concerns for M’s health are a matter for another post. I was running a fever, so I couldn’t see the babies. When my husband came into my room to see me, he noticed me cradling my belly. I was feeling the lack of sensation (which wouldn’t return for months) but he was concerned for my mental health.

“You had the babies,” he told me. “They’re not in there any more.”

“I know!” I told him, but I’m not sure he believed me.

All I could do was pump. I pumped and pumped and pumped and nothing came. I remembered a coworker telling me that his wife’s milk never came in. Their (now perfectly healthy) daughter was born so early that mom’s body interpreted the birth as a stillbirth, not a live birth. I felt like a useless hunk of meat.

My mother-in-law arrived and asked me to call my therapist. I did, and we had a session over the phone. I felt a lot better after talking through all my irrational feelings of failure at my daughters’ premature arrival.

The Second Day

My colostrum came in. I got a tiny golden drop on the side of each of two preemie bottles. I paged the nurse and asked the woman who arrived to please take the bottles to the NICU.

She picked up the bottles and turned them in the sunlight. “You want me to take this to them?” she asked incredulously.

“No,” I snapped, my dams breaking and the tears beginning to pour. “I don’t want you to take that. Give them back.”

The nurse supervisor heard me sobbing and came in to see what was going on. I told her between my sobs that I’d finally done something good for my babies, some act of actual motherhood, by producing colostrum and felt judged by the nurse for not having more. She comforted me, saying that I was right, that colostrum was liquid gold and every speck would help my babies. She would walk the colostrum over to the NICU herself. They would pour formula into the bottles to make sure that every last bit made it into my children. I should keep pumping and she would make sure I got a visit from the lactation consultant.

When my babies were 36 hours old, at 6:00 pm on their second day, my husband managed to wear someone down and convince them to let me visit the NICU. I wore a face mask since my fever was so recent.

I’d seen photos and been warned, but the NICU was overwhelming. My sense of smell was still working overtime as it had while I was pregnant. The pain from my incision when I stood from the wheelchair to scrub into the NICU mixed with the smell of the soap. I still can’t visit that hospital network and smell that soap without feeling the twinge in my uterus and heart. It’s been over 7 years.

The beeps of the machines seemed too loud and I panicked when I realized that I didn’t know which babies were mine. My husband wheeled my over and parked me between their open isolettes. I wanted to know why they weren’t being cobedded. I was told that hospital policy had recently changed and multiples were no longer allowed to share an isolette in the NICU.

I tried to hide my irritation and fear by asking about what the all the machines, wires and tubes did. The nurse surprised me by lifting M into my arms. I had no idea that I was going to be allowed to hold her. She was so small. I was reminded again of a kitten, although I confess thinking that she and her sister both looked like a cross between a lizard and a monkey. Her face and ears were still furry with lanugo. I could see where her eyebrows began only because they were was a thin line of hairlessness outlining their upper edges.

It wasn’t long before I learned that my daughters were doing exceptionally well, despite their gestational age and despite their 3 lb 6 oz and 3 lb 9 oz birth weights. They were “feeder-growers,” in the NICU only to eat and grow. Since they were born before their baby fat developed, they needed help maintaining their body temperatures outside the womb. Since they were born when they should still be nourished through the umbilical cord, feeding was a challenge. Other than size and feeding, they were perfect… apart from whatever might be wrong with M’s nose.

My own recovery was much slower and more painful than I anticipated. In my eagerness to visit the NICU, I kept tearing my staples out and reopening my incision. That too, I think, is a story for another time.

Sadia (rhymes with Nadia) has been coordinating How Do You Do It? since late 2012. She is the divorced mother of 7-year-old monozygotic twins, M and J. She lives with them and their 3 cats in the Austin, TX suburbs and works full time as a business analyst. She retired her personal blog, Double the Fun, when the girls entered elementary school and also blogs at Adoption.com and Multicultural Mothering.

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